scholarly journals The evolution of Reference Drug Lists and Clinical Practice Guidelines in the public health system of a middle-income country

2014 ◽  
Vol 78 (2) ◽  
pp. 410-421 ◽  
Author(s):  
Israel Rico-Alba ◽  
Albert Figueras
Keyword(s):  
Public Health ◽  
Clinical Practice ◽  
Health System ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Public Health System ◽  
Middle Income Country ◽  
Middle Income ◽  
Reference Drug ◽  
The Public

Fostering healthcare innovation in public hospitals: the Queensland experience

2019 ◽  
Vol 43 (6) ◽  
pp. 672
Author(s):  
Linda Mundy ◽  
Sarah Howard ◽  
Liam McQueen ◽  
Jacqui Thomson ◽  
Kaye Hewson
Keyword(s):  
Public Health ◽  
Clinical Practice ◽  
Health System ◽  
Real World ◽  
Public Health System ◽  
Public Hospitals ◽  
Policy Makers ◽  
The Public ◽  
Health Technologies ◽  
Healthcare Technologies

Faced with scarce resources and a demand for health care that exceeds supply, health policy makers at all levels of government need to adopt some form of rationing when deciding which health services should be funded in the public health system. With a relatively small investment, programs such as Queensland Health’s New Technology Funding Evaluation Program (NTFEP) fosters innovation by providing funding and pilot studies for new and innovative healthcare technologies. The NTFEP assists policy makers to make informed decisions regarding investments in new safe and effective technologies based on available evidence gathered from real-world settings relevant to Queensland patients and clinicians. In addition, the NTFEP allows appropriate patient access, especially in rural and remote locations, to potentially beneficial technologies and acts a gatekeeper, protecting them from technologies that may be detrimental or harmful. What is known about the topic? Jurisdictions have struggled to identify ways to manage the introduction of new and innovative health technologies into clinical practice. The 2009 review of health technology in Australia recommended better assessment and appraisal by ensuring real-life practices in hospitals and community settings were considered, with a consumer and patient focus. What does this paper add? Queensland Health’s NTFEP provides a robust and transparent mechanism to manage the introduction of innovative healthcare technologies into clinical practice, providing an opportunity to collect real-world data outside of formal clinical trials. These data can not only be used to inform clinical, but also purchasing, decision-making within the public health system. This model of investment and innovation has the potential to be implemented in other jurisdictions and provide opportunities to share learnings. What are the implications for practitioners? Programs such as the NTFEP provide reassurance to practitioners and patients alike that innovative healthcare technologies are adopted in public hospitals using an evidence-based approach after demonstrating that they are not only safe and clinically effective, but represent value for money and improved patient outcomes in a public health system.

Real-world biomarker testing practices in cancer treatment in a lower-middle income country in Southeast Asia.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19042-e19042
Author(s):  
Lance Isidore Garcenila Catedral ◽  
Harold Nathan Tan ◽  
Alfredo Viray Chua ◽  
Danielle Benedict Leoncio Sacdalan ◽  
Dennis Sacdalan
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Real World ◽  
The Philippines ◽  
Middle Income Country ◽  
Middle Income ◽  
Lung Cancers ◽  
Medical Oncologists ◽  
Biomarker Testing

e19042 Background: Several factors affect how medical oncologists in the Philippines, a lower middle income country, incorporate biomarkers in real-world practice. This study described patterns of use of biomarker testing for the management of breast, colorectal, and lung cancers among medical oncologists in the Philippines, where treatment is largely out-of-pocket. Methods: A cross-sectional survey was performed among practicing medical oncologists in the Philippines from November to December 2019. Responses were compiled and summarized using descriptive statistics. Results: A total of 127 responses (about 40% of medical oncologists in the country) were collected. Respondents were both consultants and fellows-in-training who, on the average, had been in oncology practice for 6.64 years (SD 7.37). Majority of respondents were affiliated with private hospitals and/or clinics (62.20%), but 40.94% of medical oncologists worked in academic medical centers. If clinically indicated and if cost did not play a role, 96% of respondents would order ER, PR and HER2neu testing for breast cancer. A quarter of respondents would include Ki-67 testing. In actual practice, 97% of the respondents reported ordering for ER/PR and 93% for HER2neu testing. For lung cancer, respondents would use EGFR (97.76%), PD-L1 (88.19%), ALK (80.31%), ROS1 (58.27%), and BRAF (33.07%). In actual practice, EGFR was the most frequently ordered biomarker (67.72%). 44.80% of medical oncologists had never used ROS1. For colorectal cancer, the respondents would use KRAS (98.43%), NRAS (81.89%), MMR/MSI (82.25%), and BRAF (63.78%), but these were only sometimes used. 59.84% of medical oncologists had never used BRAF. The strongest factor that drove medical oncologists to test for biomarkers was adherence to clinical practice guidelines (96%), with most respondents using international guidelines from the United States and Europe (61.4%). The largest barrier to biomarker use in the Philippines was financial constraints (94.5%), followed by the patients’ unwillingness to be tested (59.1%), and unavailability of tests in the areas of practice (58.27%). Conclusions: Medical oncologists in the Philippines would use biomarkers in the management of breast, colorectal, and lung cancers if these were clinically indicated and if cost did not play a role. Biomarker use was largely driven by American and European clinical practice guidelines. Financial difficulties by patients, who often had to resort to out-of-pocket payments for their treatment, formed the largest barrier to biomarker use.

scholarly journals The high cost patients on waiting list for the Liver Transplantation. main burdens and consequences for the Public Health System

2015 ◽  
Vol 18 (3) ◽  
pp. A224
Author(s):  
J.A. Turri ◽  
L.B. Haddad ◽  
W. Andrauss ◽  
L.A. D’Albuquerque ◽  
M.A. Diniz
Keyword(s):  
Public Health ◽  
Liver Transplantation ◽  
Health System ◽  
Public Health System ◽  
Waiting List ◽  
The Public

Development of a probabilistic model for quantitative risk assessment of COVID-19 in Brazil

2021 ◽  
pp. 2150069
Author(s):  
Paulo Gabriel Santos Campos de Siqueira ◽  
Alexandre Calumbi Antunes de Oliveira ◽  
Heitor Oliveira Duarte ◽  
Márcio das Chagas Moura
Keyword(s):  
Public Health ◽  
Risk Assessment ◽  
Health System ◽  
Probabilistic Model ◽  
Public Health System ◽  
The Other ◽  
Quantitative Risk Assessment ◽  
The Public ◽  
Business As Usual ◽  
Excessive Number

We have developed a probabilistic model to quantify the risks of COVID-19 explosion in Brazil, the epicenter of COVID-19 in Latin America. By explosion, we mean an excessive number of new infections that would overload the public health system. We made predictions from July 12th to Oct 10th, 2020 for various containment strategies, including business as usual, stay at home (SAH) for young and elderly, flight restrictions among regions, gradual resumption of business and the compulsory wearing of masks. They indicate that: if a SAH strategy were sustained, there would be a negligible risk of explosion and the public health system would not be overloaded. For the other containment strategies, the scenario that combines the gradual resumption of business with the mandatory wearing of masks would be the most effective, reducing risk to considerable category. Should this strategy is applied together with the investment in more Intensive Care Unit beds, risk could be reduced to negligible levels. A sensitivity analysis sustained that risks would be negligible if SAH measures were adopted thoroughly.

scholarly journals Neutralization of B.1.1.28 P2 variant with sera of natural SARS-CoV-2 infection and recipients of BBV152 vaccine

2021 ◽  
Author(s):  
Gajanan Sapkal ◽  
Pragya Yadav ◽  
Raches Ella ◽  
Priya Abraham ◽  
Deepak Patil ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Natural Infection ◽  
Vaccination Program ◽  
Vaccine Regimen ◽  
The Public ◽  
Neutralizing Potential ◽  
Dose Vaccine

The emergence of new SARS-CoV-2 variants has been a serious threat to the public health system and vaccination program. The variant of concerns have been the under investigation for their neutralizing potential against the currently available COVID-19 vaccines. Here, we have determined the neutralization efficacy of B.1.1.28.2 variant with the convalescent sera of individuals with natural infection and BBV152 vaccination. The two-dose vaccine regimen significantly boosted the IgG titer and neutralizing efficacy against both B.1.1.28.2 and D614G variants compared to that seen with natural infection. The study demonstrated 1.92 and 1.09 fold reductions in the neutralizing titer against B.1.1.28.2 variant in comparison with prototype D614G variant with sera of vaccine recipients and natural infection respectively.

scholarly journals Amalgam versus resin composite for the restoration of posterior teeth: disparities between public clinical practice and dental education in southern Brazil

2011 ◽  
Vol 52 (1/3) ◽  
pp. 33-37
Author(s):  
Clarissa Fatturi Parolo ◽  
Aline Macarevich ◽  
Juliana Jobim Jardim ◽  
Marisa Maltz
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Resin Composite ◽  
Dental Students ◽  
Restorative Material ◽  
Chi Square ◽  
Posterior Teeth ◽  
The Public ◽  
Dental Schools

Purpose: To compare the restorative material used in the treatment of posterior teeth taught and performed in two Dental Schools (UFRGS and ULBRA) and in 8 basic health units (BHU) from the Public Health System in Porto Alegre, Brazil. Materials and methods: Data referring the teaching of restorative procedures using amalgam (AM) or resin (R) were obtained through the analysis of patient’s files and questionnaires applied to final year dental students. Information regarding restorative procedures at BHU was obtained through patient’s records and a questionnaire applied to the dentists. The type of restorative material used in both BHU and Dental Schools were compared by chi-square test. Results: At UFRGS, 327 restorations were performed, 78.28% R and 21.72% AM, and at ULBRA 366 restorations, 92.63% R and 7.37% AM. At BHU, 1664 restorations were performed (35.93% R and 64.07% AM). A major proportion of AM restorations was performed in the Public Health Service in comparison to both Dental Schools, in which resin restorations prevailed (p=0.000). Conclusion: The change from AM to R in the dental material choice for posterior teeth at Dental Schools was not followed by the Public Health System, where the AM is still widely used in posterior teeth.

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